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Criteria

  • Required to be a Chaves County resident for more than ninety (90) days prior to the date of treatment.
  • Applicant's income must comply with the Income Criteria below, if the household income exceeds the income schedule below, a medical spend down must be included. (A medical spend down is any medical and pharmacy payments and or insurance premiums made by members of the household within the last three months prior to the current services rendered. It does not include payments made by an insurance provider.) If you make monthly child support payments, that can also be used to help your household meet our income guidelines. (Include proof with your application.)

Income Schedule

Persons Annual Income Monthly Income
1 19,248 1,604
2 25,908 2,159
3 32,568 2,714
4 39,228 3,269
5 45,888 3,824
6 52,548 4,379
7 59,208 4,934
8 65,868 5,489

Add $6,660 for each additional person. An expectant mother’s unborn child will be included in determining income.

Note: An expectant mother's unborn child will be included in determining the family or household eligibility. Add $6,660 for each additional household member.

 

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